A survey of fertility and sexual health following allogeneic haematopoietic stem cell transplantation in New South Wales, Australia

  • Gemma Dyer
    Northern Clinical School Faculty of Medicine University of Sydney Sydney NSW Australia
  • Nicole Gilroy
    Blood and Marrow Transplant Network New South Wales Agency for Clinical Innovation Sydney NSW Australia
  • Jennifer Bradford
    Department of Obstetrics & Gynaecology Westmead Hospital Sydney NSW Australia
  • Lisa Brice
    Department of Haematology Royal North Shore Hospital Sydney NSW Australia
  • Masura Kabir
    Westmead Breast Cancer Institute Sydney NSW Australia
  • Matt Greenwood
    Northern Clinical School Faculty of Medicine University of Sydney Sydney NSW Australia
  • Stephen R. Larsen
    Institute of Haematology Royal Prince Alfred Hospital Sydney NSW Australia
  • John Moore
    Department of Haematology St Vincent Hospital Sydney NSW Australia
  • Mark Hertzberg
    Department of Haematology Prince of Wales Hospital Sydney NSW Australia
  • John Kwan
    Department of Haematology Westmead Hospital Sydney NSW Australia
  • Louisa Brown
    Department of Haematology Newcastle Mater Hospital Sydney NSW Australia
  • Megan Hogg
    Department of Haematology Westmead Hospital Sydney NSW Australia
  • Gillian Huang
    Department of Haematology Westmead Hospital Sydney NSW Australia
  • Jeff Tan
    Department of Haematology St Vincent Hospital Sydney NSW Australia
  • Christopher Ward
    Northern Clinical School Faculty of Medicine University of Sydney Sydney NSW Australia
  • Ian Kerridge
    Northern Clinical School Faculty of Medicine University of Sydney Sydney NSW Australia

説明

<jats:title>Summary</jats:title><jats:p>Four hundred and twenty‐one adult allogeneic haematopoietic stem cell transplant (<jats:styled-content style="fixed-case">HSCT</jats:styled-content>) survivors participated in a cross‐sectional study to assess sexual dysfunction and infertility post‐transplant. Survey instruments included the Sydney Post‐Blood and Marrow Transplant (<jats:styled-content style="fixed-case">BMT</jats:styled-content>) Survey, Functional Assessment of Cancer Treatment (<jats:styled-content style="fixed-case">FACT</jats:styled-content>) – BMT, the Depression, Anxiety, Stress Scales (<jats:styled-content style="fixed-case">DASS</jats:styled-content> 21), the Chronic Graft‐versus‐Host Disease (<jats:styled-content style="fixed-case">cGVHD</jats:styled-content>) Activity Assessment‐ Patient Self Report (Form B), the Lee <jats:styled-content style="fixed-case">cGVHD</jats:styled-content> Symptom Scale and The Post‐Traumatic Growth Inventory. Most HSCT survivors reported sexual difficulties (51% of males; 66% of females). Men reported erectile dysfunction (79%) and decreased libido (61·6%) and women reported loss of libido (83%), painful intercourse (73%) and less enjoyment of sex (68%). Women also commonly reported vaginal dryness (73%), vaginal narrowing (34%) and vaginal irritation (26%). Woman had much higher rates of genital cGvHD than men (22% vs. 5%). Age and <jats:styled-content style="fixed-case">cGVHD</jats:styled-content> were significantly associated with sexual dysfunction. Few survivors had children following transplant (3·3%). However, for those of reproductive age at <jats:styled-content style="fixed-case">HSCT</jats:styled-content>, 22% reported trying to conceive, with 10·3% reporting success. This study is the largest to date exploring sexual function in survivors of allo‐<jats:styled-content style="fixed-case">HSCT</jats:styled-content>. This data provides the basis for health service reform to better meet the needs of <jats:styled-content style="fixed-case">HSCT</jats:styled-content> survivors, including evidence to support counselling and education both pre‐ and post‐transplant.</jats:p>

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